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NPI 1811783442

NPI 1811783442 : MEIEO WASHBURN : MARIETTA, GA

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General NPI Number Information
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    NPI Number           |    1811783442
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    Entity Type          |    Individual 
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    Provider Name        |    MEIEO WASHBURN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/18/2025
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    Last Update Date     |    04/18/2025
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Provider Practice Location Address
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    Address Line         |    222 RIPPLING DR NW 
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    City                 |    MARIETTA
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    State                |    GA
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    Zip                  |    30064-1844
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    Country              |    US
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    Telephone            |    801-550-2651
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    222 RIPPLING DR NW 
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    City                 |    MARIETTA
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    State                |    GA
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    Zip                  |    30064-1844
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    Country              |    US
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    Telephone            |    801-550-2651
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    163WC0400X
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    Taxonomy Name        |    Case Management Registered Nurse
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    License Number       |    RN61667572
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    License Number State |    WA
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